Can we all agree that the picture here is adorable?
And that we would all shake our heads in agreement if this saying was plastered on some Self-help magazine?
“Yes, yes”, you would all say, “you can’t sail the open sea if you never leave shore!”
And then we would all join hands and talk about our hopes and dreams and how great things are going to be…
But what if that first step is more than just a little “scary”? What if that first step actually causes you debilitating pain? You know the one I’m talking about: that first step of the morning-swing legs over bed ledge-get ready to face the day-oh-oh- my god-the pain-my heels…not today…not today…”
That is no way to start the day.
And it certainly is not going to motivate someone to get active. For most of us out there, the thought of going to the gym or lacing up shoes for a jog is already daunting enough as a conceptual activity. Throw in shooting pain induced from simply applying body weight pressure…? Um, no thanks. Not happening.
According to the American Academy of Orthopedic Surgeons [AAOS], two million people are treated annually for this “first step of the morning” pain. Its fancy name is Plantar Fasciitis, or to the laymen, simply, “Heel Spur Syndrome”.
Cue: Mini Anatomy Lesson
What is plantar fasciitis?
Simply put, plantar fasciitis is inflammation of the plantar fascia – the thick band of tissue that runs across the bottom of the foot and connects the heel bone [aka “calcaneus” bone] to the toes and supports the arch of the foot.
Remember, inflammation is the body’s natural response to injury, so if your fascia is inflamed it’s because the tissue has been ripped, torn, or possibly stretched past its normal capacity.
How Do I know if I have plantar fasciitis?
A few stock items the Foot Doctor [aka “podiatrist”] is going to assess to determine if you have plantar fasciitis are :
 the type of pain – pain categorized as “stabbing” pain is dominant with plantar fasciitis
 timing and duration of pain – always associated with pain that is worst in the morning or after long periods of standing or sitting and then gradually lessens as the day progresses and movement continues
 where the pain is located – associated with maximum tenderness on the bottom of the foot in front of heel and when toes are flexed in an upwards position. If you only meet some of these pre-requisites, your podiatrist should take an X-ray to rule out stress fractures in the foot , heel, and ankle.
Why Might I have plantar fasciitis?
As mentioned above, it results from fascia that has been forced to withstand conditions that overwhelm it on some level causing it to rip tear, or stretch. Being that it forms the sole support [pun intended, but literally…] of the foots arch, the fascia is naturally very thick and sturdy; this is a great thing for the arch under normal conditions but renders it inflexible and unable to stretch the way we force it to sometimes. The top 5 factors that contribute to the ripping, tearing, stretching, and ultimate inflammation of the fascia are:
 sudden increase in impact activity (i.e. new runner)
 tight, inflexible calf muscles
 naturally occurring high arch (and not wearing the proper shoes for this arch type)
 chronic, sustained impact activity (i.e. long-time runner)
Common Consequences of plantar fasciitis
Obviously, pain, we’ve sort of covered that – so what else?
Well, because as humans we tend to shy away from the uncomfortable, anytime there is pain in the body, we subconsciously “favor” the pained area. Now sometimes this is necessary – like with a broken bone – when additional pressure can cause immediate, threatening damage. However, the idea is that you are getting that broken bone taken care of ASAP and not hobbling around on it for years. BUT those suffering from inflamed fascia often go months to years before seeking proper tools for recovery because [as mentioned above] the pain tends to lessen as the day goes on – and let’s face it – anymore, unless we are coughing up a lung or bleeding from the eye ball, we can’t stand sitting at the doctor’s office…using our precious PTO to sit in the most sterile, yet germ-ridden places on the planet? Only to see the “No cell phones” sign? And the drab receptionist starring you down as you curse the crummy 3G network? “Heel Pain-Schmeel Pain” you’ll say…
You laugh, but it’s so true.
The problem is, when you favor your feet over time, you end up causing knee, hip, and back problems because everything else shifts over to compensate for your “favoring” technique.
Another common thing we see along-side plantar fasciitis is a heel spur. A heel spur is simply a growth of the heel bone in an area it isn’t naturally projected to go. When it comes to plantar fasciitis, this projection is on the underside of the bone where the fascia is connected. This makes sense because, remember, the ripping and tearing happens when the fascia is stretched too far, so your body, in all its infinite wisdom, tries to take care of the problem on its own and figures “hey, that fascia isn’t getting any longer, so let’s just grow some more bone! If it sticks out further and the fascia is connected there, it won’t have to stretch so far!” Sort of brilliant for autonomous functions actually.
***Please note, if your podiatrist recommends removal of the heel spur as the sole resolution [last pun I swear…] to “solve” your plantar fasciitis, I strongly urge you to seek a second opinion as that is a rather invasive idea that rarely yields a solution.
What can I do to help myself if it is determined that I have plantar fasciitis?
Wiggle your nose, touch something purple, spin a quarter turn to the right…and voila!
[Wait, unless that worked for you, then please contact me directly and we’ll join the circus together…]
I’m going to level with you, most of the online information is misleading. For instance, there are hundreds of articles about plantar fasciitis “foot stretches”.
Yikes! This should blow your mind…. Remember this whole problem started from stretching, did it not? Two wrongs do not make a right. As for the night braces and steroid injections… huge waste of money and very little research to back up longitudinal success.
SO what does work? Well, since tight calf muscles are the top contributing factor for all three of our priority population mentioned above (those who are obese, those who have sudden increase in impact activity, and those who long-time impact athletes), I have three solid recommendations:
 Massage and loosen up the calf muscle for a few minutes daily – if you are going to STRETCH anything, stretch your calf muscles. There are several simple stretches you can do that do not require professional assistance or equipment. Below you will see some pictures showing common household items that you may use to assist in calf stretches. This is a great start. For those looking to take it a step further, MissFit swears by foam rolling Click on that hyperlinked texted to read the post about safe foam rolling.
 Do some kind of activity to help shed excess weight – in conjunction with healthy eating habits, select low-impact aerobic activity such as swimming, recumbent bikes, and the elliptical machines.
The #1 most successful way to recover from plantar fasciitis is to wear insoles specially designed for the degree of pronation [aka “collapsed arch] you suffer from. These can be fit and ordered through your podiatrist but could be upwards of $100. Honestly, if worn consistently as prescribed, insoles alone can reverse the majority of complications of plantar fasciitis because they re-align the foot, arch, ankle, and back and give the fascia the rest it needs to heal properly. If that doesn’t sound like it’s worth $100, feel free to start out with over-the-counter shoe inserts for some relief. Lastly, and equally as important, is the shoes that you put the insoles in.
This video does a remarkable [and adorable] job of explaining the Do’s and Don’ts of shoe buying for plantar fasciitis. Check it out and please let me know if you have any other questions!